Narcissists: Pathologise them or...?

Popular frameworks for understanding narcissism – especially in media and self-help contexts – often emphasise labelling behaviours as “narcissistic” or “toxic.” While such frameworks can validate the experiences of those harmed by difficult behaviours, their widespread social application can also lead to over-pathologising, relational rigidity, and unintended harm. 

This article explores the consequences of pathologising in the context of narcissism, shows how it can replicate the very traumas that shaped narcissistic behaviours, and contrasts this with the humanistically oriented framework of internal family systems (IFS) and partswork, which emphasises empathy, curiosity, and relational repair. Practical strategies for engaging safely and constructively with individuals who may display narcissistic traits are also provided.

What is pathologising?

Pathologising occurs when someone’s behaviour, personality trait, or coping mechanism is treated as a defect, disorder, or disease – often without professional evaluation.

• Beyond diagnosis: Unlike a clinical diagnosis, which carefully evaluates according to established criteria, pathologising is judgmental, oversimplified, and often shaming - it is a one above superior position that condescends.
• Behaviour vs. identity: It treats one behaviour as defining the whole person.
• Ignoring context: It overlooks trauma, unmet needs, or social stressors that may have shaped the behaviour.
• Cycles of harm: Premature labelling often triggers defensiveness or rigid patterns, replicating the very dynamics that created the behaviour.

Example:

• Pathologising: “She’s a toxic narcissist – stay away.”
• Non-pathologising/partswork lens: “She seems very controlling right now; I wonder if she’s experiencing something that feels unsafe or unheard. I’ll set my boundaries while staying curious towards that.”

From a partswork perspective, pathologising overlooks the protective functions of the psyche’s inner parts. Instead of judging, we pause and ask: “What is this behaviour trying to protect?” This shift keeps both parties humanised and creates space for relational repair with a voice of inclusion.

Pathologising in context: Why it can be harmful

Pathologising is not merely about labelling someone “sick” or “disordered.” It reduces complexity and can cause relational harm because it:

1. Ignores systemic context – Behaviours are treated as isolated flaws, without considering social, relational, or cultural factors. Example: Controlling behaviour may reflect a history of neglect, trauma, or environments where needs were chronically dismissed.
2. Flattens complexity – It collapses a multi-faceted person into a single label, ignoring the protective and adaptive parts of the psyche that developed for survival.
3. Generates shame and distance – Labelling fosters unneeded defensiveness, blame, and disconnection rather than understanding and repair.

Pathologising can also function as an institutional force – a kind of meta-message that circulates through social systems. While it may appear authoritative, it often contradicts and quashes the natural empathic instincts of those within the system.

In short, pathologising sees people through a linear lens – narrow, judgmental, and without curiosity. Systemic partswork, by contrast, offers a circular lens: every behaviour is understood as a protective strategy within a wider system of needs and experiences, which allows for repair, growth, and healing.

Pathologising narcissism: Risks and social consequences

Dr. Ramani Durvasula, a clinical psychologist, has helped popularise a linear understanding of narcissistic behaviours, highlighting traits such as lack of empathy, entitlement, and grandiosity (Durvasula, 2019). Her influence has reached wide audiences, many of whom follow the stance through books, media, and online platforms, where her work has helped many people feel validated in difficult relationships.

However, there is growing concern that in some contexts, these frameworks may foster a culture of weaponised labelling. When concepts are taken up in popular discourse without nuance, they can sometimes escalate into polarised movements that risk oversimplifying complex human dynamics. This raises ethical and social concerns, as it can encourage adversarial rather than empathic engagement.

The risks include:

• Over-pathologising ordinary defences such as insecurity or self-protection.
• Reinforcing rigid protector strategies in observers, who may respond with moral superiority or dismissal.
• Replicating trauma: Many individuals develop narcissistic traits as protective responses to neglect, criticism, or invalidation. Labelling them as inherently “toxic” risks recreating the very shame and rejection that wounded the person and gave rise to those traits.

Sam Vaknin’s deterministic framing in Malignant Self-Love (1999) amplifies these risks by portraying narcissists as irreparable. This view fosters hopelessness and rigid social labelling and stonewall shaming abuses. Given his own diagnosis of NPD, Vaknin may even view himself as irreparably defective – a stance that can be both tragic and a misleading projective identity.

The trauma mirror: How pathologising replicates narcissistic origins

Narcissistic behaviours often arise as protective strategies in response to early trauma:

• Grandiosity and entitlement shield vulnerable inner parts from shame and neglect.
• Manipulation or control may emerge as survival strategies in unpredictable or invalidating environments – sometimes reinforced by rigid systemic or cultural rules.

When outsiders respond by shaming, labelling, or dismissing these behaviours, it mirrors and adds to the original invalidation or neglect the person is already enduring. In this way, pathologising can unintentionally re-enact the trauma, deepening cycles of defensiveness and rigidity in both the labelled person and those around them.

Partswork and a humanistic lens

Partswork explores the inner system of the person, attending to the emotional functions of each part and the contexts that shaped them.

Dr. Frank Anderson, M.D., a Harvard-trained psychiatrist and IFS expert, advocates for a trauma-informed, non-pathologising approach:

1. Behaviour vs. Self – Distinguish protective behaviours from the core essence of the person.
2. Empathy for protective parts – Recognise that even manipulative or self-absorbed behaviours are efforts to shield vulnerable inner parts.
3. Curiosity over judgment – Observe without labelling, while maintaining therapeutic boundaries.
4. Mutual healing – Encourage relational repair and personal growth, compassion, reducing cycles of shame and defensiveness.

By applying a partswork lens, we can break trauma cycles and offer empathy rather than reinforcing protective invalidation.

Integrating systemic trauma healing approaches

Recent research highlights the importance of systemic, trauma-informed perspectives in addressing narcissistic injury:

• Narcissistic injury and early trauma – Many narcissistic traits develop as protective responses to deep emotional wounds (Montoro et al., 2022).
• Attachment-based interventions – Building trust and safety is crucial when working with individuals exhibiting narcissistic defences (therapywisdom.com).
• Human givens approach – Meeting innate emotional needs and developing resources restores balance, reduces maladaptive defences, and fosters lost resilience (Griffin & Tyrrell, 2003).

Practical guidance for non-clinicians

Even outside professional contexts, you can engage safely and constructively with someone who may have narcissistic traits:

A. Protect yourself without reactivity

• Set clear boundaries and know your limits.
• Avoid trying to “out-narcissist” the person – this escalates conflict.
• Notice your own emotional triggers with self-compassion; they often signal your own protector parts reacting to perceived danger (both externally and internally).

B. Respond with curiosity, not labels

• Focus on behaviours rather than diagnoses.
• Use reflective statements: “When X happens, I feel Y.”
• Avoid shaming or stonewalling, as these replicate the early invalidation that may have shaped the person’s defences.

C. Encourage relational repair when possible

• Acknowledge emotions without reinforcing entitlement.
• Offer choice and autonomy where appropriate.
• Stay empathic while maintaining your boundaries.

Pathologising narcissistic behaviours risks recreating the very dynamics that shaped them: shame, rejection, and invalidation. Labelling can itself become narcissistic – rigid, superior, and lacking empathy.

A humanistically informed, partswork-based approach, enriched by systemic and trauma-sensitive frameworks such as human givens and attachment-based interventions, offers a safer and more constructive alternative. By recognising protective intentions, staying curious, and holding firm, wholesome boundaries, we can reduce harm and create safe, inclusive conditions for relational growth and emotional transformation.

References

1. Durvasula, R. (2019). Should I Stay or Should I Go? Surviving a Relationship with a Narcissist. New York: Atria Books.
2. Vaknin, S. (1999). Malignant Self-Love: Narcissism Revisited. Narcissus Publications.
3. Anderson, F. (2022). Internal Family Systems Therapy: Trauma-Informed Approaches. Trauma Research Foundation.
4. Montoro, C. I., de la Coba, P., & Padilla, M. M. (2022). Narcissistic Personality and Its Relationship with Post-Traumatic Symptoms and Emotional Factors. Psychiatry Research, 303, 114115.
5. Griffin, J., & Tyrrell, I. (2003). Human Givens: A New Approach to Emotional Health and Clear Thinking. HG Publishing.
6. Journal of Clinical Psychology (2025). Treating a Narcissist: Reframing the Narcissistic Wound. Journal of Clinical Psychology, 81(4), 789–802.